View Full Version : Reduced Daytrana.


Castleton Snob
10-14-15, 02:20 PM
My pharmacy didn't have 30 mgs of Daytrana patches, so I have to use 20 mgs until December.
What can I expect? Will there be a difference?

namazu
10-14-15, 02:24 PM
Wow, I'm surprised they substituted them like that -- did they call your doctor first to be sure it was OK?

I would guess the main thing you may notice -- assuming 30mg is the most effective dose for you -- is that the 20mg patches will not provide as much symptom control as the 30mg patches.

(If they work just as well, you could maybe consider switching to 20mg for good.)

Castleton Snob
10-14-15, 02:28 PM
Wow, I'm surprised they substituted them like that -- did they call your doctor first to be sure it was OK?

I would guess the main thing you may notice -- assuming 30mg is the most effective dose for you -- is that the 20mg patches will not provide as much symptom control as the 30mg patches.

(If they work just as well, you could maybe consider switching to 20mg for good.)

We had to get my Dr. to write a new prescription.

What do I do?

namazu
10-14-15, 02:29 PM
If your doctor was on board with it, and there's no pharmacy nearby that could fill a 30mg Daytrana prescription, I guess you stick with the 20mg for the month.

Worst case scenario, your ADHD will be out in full force for the month.

Best case scenario, you won't notice a difference.

Hope it works out for the best!


EDIT: I would also suggest, if you notice that the 20mg patch doesn't cut it as far as symptom control is concerned, talk to the pharmacist and let him/her know that you'll have a script for the 30mg patches on December 1 (or whenever), and if they could please order it in advance so they have it in stock, that would be great... Assuming there's not a shortage of it, and they just happened to be out because they didn't anticipate the demand for it, that may take care of the problem in the future.

Castleton Snob
10-14-15, 02:33 PM
If your doctor was on board with it, and there's no pharmacy nearby that could fill a 30mg Daytrana prescription, I guess you stick with the 20mg for the month.

Worst case scenario, your ADHD will be out in full force for the month.

Best case scenario, you won't notice a difference.

Hope it works out for the best!

But I go to college. I might not be able to focus.

What can I do?

namazu
10-14-15, 03:26 PM
Well, can you try the 20mg patches this weekend and see how it goes?

You may find that the 20mg works OK.

If you find that they don't work, maybe your doctor can write a new 30mg script and you can get that filled somewhere? Even giving a heads-up to your current pharmacy on Monday that the 20mg didn't work and your doctor's writing a new 30mg script and could they please order a month's worth of 30mg patches ASAP might do the trick.

Or maybe, if you're able to swallow pills, your doctor could prescribe a low dose of Ritalin in pill form (maybe 5-10mg?) to help get you through the month, if the 20mg Daytrana doesn't cut it by itself?

And supplementing the meds with a combination of exercise and maybe a little caffeine (but go easy on it -- caffeine + stimulants can be too much for some people) and taking regular breaks and being careful to get enough sleep and nutritious food could help.

As far as school, specifically -- have you been in contact with your school's office of disability services (or whatever it's called at your school)? You may be able to get accommodations, if needed. (For example, extensions on some deadlines this month if you're having trouble getting stuff done due to the change in meds.)

Don't panic -- you'll get through this! Hang in there.

Castleton Snob
10-14-15, 03:33 PM
Well, can you try the 20mg patches this weekend and see how it goes?

You may find that the 20mg works OK.

If you find that they don't work, maybe your doctor can write a new 30mg script and you can get that filled somewhere? Even giving a heads-up to your current pharmacy on Monday that the 20mg didn't work and your doctor's writing a new 30mg script and could they please order a month's worth of 30mg patches ASAP might do the trick.

Or maybe, if you're able to swallow pills, your doctor could prescribe a low dose of Ritalin in pill form (maybe 5-10mg?) to help get you through the month, if the 20mg Daytrana doesn't cut it by itself?

And supplementing the meds with a combination of exercise and maybe a little caffeine (but go easy on it -- caffeine + stimulants can be too much for some people) and taking regular breaks and being careful to get enough sleep and nutritious food could help.

As far as school, specifically -- have you been in contact with your school's office of disability services (or whatever it's called at your school)? You may be able to get accommodations, if needed. (For example, extensions on some deadlines this month if you're having trouble getting stuff done due to the change in meds.)

Don't panic -- you'll get through this! Hang in there.

I think the pharmacy said nobody in town had it. Or maybe it was in the state.

What if my mom won't let me?

namazu
10-14-15, 03:41 PM
What wouldn't your mom let you do?

If there's a local or state-wide shortage of 30mg Daytrana, and the 20mg Daytrana doesn't work well enough, then you'll just have to fight through (or consult with your doctor about alternatives, maybe pills or liquid methylphenidate). (I didn't see it in the list of drug shortages here (http://www.accessdata.fda.gov/scripts/drugshortages/default.cfm), but you could report it if it turns out to be a problem.)

If it's just out of stock at your local pharmacy, they should be able to order it for you -- though it could take a week or 2 to arrive.

Castleton Snob
10-14-15, 03:51 PM
What wouldn't your mom let you do?

If there's a local or state-wide shortage of 30mg Daytrana, and the 20mg Daytrana doesn't work well enough, then you'll just have to fight through (or consult with your doctor about alternatives, maybe pills or liquid methylphenidate). (I didn't see it in the list of drug shortages here (http://www.accessdata.fda.gov/scripts/drugshortages/default.cfm), but you could report it if it turns out to be a problem.)

If it's just out of stock at your local pharmacy, they should be able to order it for you -- though it could take a week or 2 to arrive.

What if she won't let me take another med?

I'm pretty sure I'm supposed to have a Dr's appointment this month. That'd be a good time to talk about it.

namazu
10-14-15, 04:03 PM
Daytrana's active ingredient is methylphenidate.

This is the same active ingredient as in Ritalin, Concerta, Quillivant (a liquid form), and some other meds. So basically, it's the same active ingredient (methylphenidate), just in a different form (patch vs. pill or liquid).

I don't know your mom, but:

a) I assume she'd probably want you to have the best treatment for your ADHD, and if the 20mg Daytrana patches don't work, that may mean working with your doctor to find an OK substitute, and

b) if you're in college, you're probably an adult, legally -- and even if you're on your mom's insurance, you should be able to make medical decisions with your doctor without necessarily needing your mom's OK.

In any case, the best solution would be to find a pharmacy that either carries, or is willing to order and keep in stock, the 30mg Daytrana that you're used to and that has worked for you until now.

I agree with you, though, that this would be good to discuss with your doctor at your visit this month.

If you have the 20mg patches at home already, it might be worthwhile to try them before you see the doctor, so you can determine whether or not they do the job. If so, no worries -- you can just use the 20mg patches. If not, and the pharmacies near you can't help with the 30mg Daytrana, then talk to the doctor about your other medication options, or about mail-order pharmacy options (if available in your state and with your insurance).

It would be a shame not to treat your ADHD adequately if there are good options available to you. I hope it all works out fine for you.

Castleton Snob
10-14-15, 04:19 PM
We already talked about mail-order. I think they said that wouldn't work.

Castleton Snob
10-15-15, 09:06 AM
Also, my mom said the 30 mg Daytrana shortage is nationwide.

namazu
10-15-15, 02:01 PM
Also, my mom said the 30 mg Daytrana shortage is nationwide.

Hmm. It's not listed in the FDA's database of current drug shortages (http://www.accessdata.fda.gov/scripts/drugshortages/default.cfm) at the moment. Sometimes it takes a while (and reports from people like you!) for shortages to be included in the list.

On the Daytrana website, however, there's this:

Important Message

Please note, starting October 1, 2015 there is a shortage of DaytranaŽ (methylphenidate transdermal system) 30mg patches that is expected to last for 30-60 days. The Pharmacy Locator Service (1-800-420-2719) can potentially help identify a pharmacy that may have Daytrana 30mg in stock. If you are unable to find a pharmacy that still has Daytrana in stock, please contact your doctor.

That's consistent with the lack of stock at your pharmacy and what your mom said.

You(or your mom, or the pharmacy) should consider reporting it to the FDA (http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm142398.htm) so they can look into it. (They may have already heard from the company or from pharmacies, but the more reports they receive, the more likely they are to acknowledge the shortage.)

Also, try the "pharmacy locator" phone number to see if there's any place that has the 30mg in stock.

If not, you're back to "contact your doctor" regarding alternatives.

Have you tried the 20mg patch yet? If it works OK, then maybe there's no need to worry.

Castleton Snob
10-15-15, 02:19 PM
Hmm. It's not listed in the FDA's database of current drug shortages (http://www.accessdata.fda.gov/scripts/drugshortages/default.cfm) at the moment. Sometimes it takes a while (and reports from people like you!) for shortages to be included in the list.

On the Daytrana website, however, there's this:



That's consistent with the lack of stock at your pharmacy and what your mom said.

You(or your mom, or the pharmacy) should consider reporting it to the FDA (http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm142398.htm) so they can look into it. (They may have already heard from the company or from pharmacies, but the more reports they receive, the more likely they are to acknowledge the shortage.)

Also, try the "pharmacy locator" phone number to see if there's any place that has the 30mg in stock.

If not, you're back to "contact your doctor" regarding alternatives.

Have you tried the 20mg patch yet? If it works OK, then maybe there's no need to worry.

You think it'd be worth a try to use the pharmacy locator phone number? But I just said my mom said there's none nationwide.

I'm surprised I didn't find anything on Google. I would have thought there'd be more about it.

If it doesn't work, I don't know what to do. I can't try another med, because I already take a lot of oral meds.

namazu
10-15-15, 02:39 PM
You think it'd be worth a try to use the pharmacy locator phone number? But I just said my mom said there's none nationwide.
Well, you have nothing to lose, right? Sometimes one pharmacy will have a pack sitting on the shelf even though other pharmacies are sold out.

Chances are, you won't find any -- but it can't hurt to inquire.

(If your mom already called this number, and they told her there's none, then don't bother calling again.)


If it doesn't work, I don't know what to do. I can't try another med, because I already take a lot of oral meds.
Yes, that's a tough situation. :grouphug:

In terms of school, if you find you can't function well enough on 20mg Daytrana, and your doctor doesn't have any great ideas regarding other forms of methylphenidate, could you consider taking a leave of absence, or getting medical incompletes or withdrawals for your courses this term? (That would prevent the medication situation from adversely affecting your grades, and would give you a chance to get things straightened out. However, be aware that there could be financial aid implications of this, and check those out in advance.)

Again, this would be something for whatever office deals with disability accommodations to handle with you. If you don't already have documentation of your ADHD (and any other conditions contributing to your disability) on file with them, now would be a good time to get that in order.

On the bright side, the manufacturer seems to think this shortage will be resolved within a month or two. So hopefully by spring semester everything should be back to normal.

Castleton Snob
10-15-15, 02:45 PM
My mom also said that the reason is because they didn't anticipate the demand for it.

Castleton Snob
10-15-15, 08:00 PM
Also, I take online classes.

I could work ahead until this straightens out.

a6z6nhd2zq@cts.
10-24-15, 01:18 AM
my sister uses the patch. Her Dr said it is OK to cut them-so she is applying a 20 and a half of another 20 per day.